Thomas Hicks, SUDRC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

445 W Weber Ave Ste 129
Stockton, CA 95203-3146

Phone

(209) 451-3628

NPI assigned

Sep 30, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1194497891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 W WEBER AVE STE 129",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952033146",
            "telephone_number": "209-451-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 W WEBER AVE STE 129",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952033146",
            "telephone_number": "209-451-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "THOMAS",
        "credential": "SUDRC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "smarchese@servicefirstnc.org",
            "affiliation": "N",
            "address_1": "445 W Weber Ave Ste 129",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952033146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tanner Hickman
• Peter G Hickox, M.D.
• Dejah Hicks
• Kristen Hicks
• Shiannah Hicks
• Rachel Dianne Hieb, DO
• Richard Lee Higgins IV
• Christiane Highfill
• Kyjah Hightower
• Hikmat T Fikrat

• Addiction (Substance Use Disorder) Counselor in Stockton, CA
• Providers in Stockton, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.